Editor’s note: Wellness Word is an informational column which is not meant to replace a healthcare professional’s diagnosis, treatment or medication.

February is American Heart Month and a good time to remind ourselves to take care of our hearts. After all, it is the only one we’ve got. One in four deaths annually in the US is due to heart disease and it is a major burden in the cost of healthcare.

Several factors can predispose us to heart disease and some we can change and others not. Those we can’t change include our genetics. So let’s focus on what we can change to make our heart and lives healthier. Small changes can do a lot.

Eat healthy – Obesity and diabetes are a major risk factor for heart disease including heart attacks. There are several things you can do to get to a healthier weight. Add more fruits, healthy grains and vegetables to you diet, the more the better. Start reducing processed food which contains a lot of sodium and preservatives. Decrease the amount of saturated fat and trans fat in your diet as well and these are usually contained in animal-based products including dairy. A whole food, plant-based diet, Mediterranean diet or DASH diet is an alternative something to consider.

Exercise – Being sedentary is a risk factor for heart disease. As society’s mechanization increases, we have become more sedentary. Try to avoid sitting for long periods of time. Aim for about 150 minutes of moderate exercise like brisk walking or 75 minutes of vigorous exercise like jogging in a week.

Most studies show that resistance training twice a week seems to be helpful. You don’t need a gym membership to do this. Incorporate activity all throughout your day. Walk or bike to work when you can. Take the stairs instead of the elevator, get off the bus sooner than your designated stop and walk the rest of the way or park farther from entrances. Housework and yard work can also be helpful in decreasing sedentary ways.

Sleep well – The mechanisms of sleep fragmentation and sleep deprivation causing heart disease are not exactly well-established but it is known that they are linked. For example, people with sleep apnea, with frequent awakenings at night, have an increased risk for diabetes, strokes and heart disease.

The National Sleep Foundation recommends seven to nine hours of sleep for adults, and this number is higher in teens and children. If you have a sleep disorder like insomnia or sleep apnea, make sure you talk to your doctor about sleep hygiene and other available treatment.

Make sure you keep your bedroom conducive for sleep; dark, comfortable and noise free. Avoid alcohol and caffeine close to bedtime. Turn off electronics and anything with bright screens a few hours before bedtime, ideally four  hours. Exercise and being active in the daytime helps with sleep but don’t do this too close to bedtime as this can be stimulating.

Relieve Stress – Just like sleep, the mechanism by which stress causes heart disease is not yet well understood. It does lead to increases in stress hormones that can lead to a detrimental cascade of increased heart rate and elevated blood pressure.

Stress can lead to unhealthy habits like not eating well and being inactive. Find ways to relieve stress with guided meditation, hiking and being with friends. Being grateful and keeping a gratitude journal seems to be helpful for some people as well.

Stop Smoking and Avoid Second Hand Smoke – If there is one thing that has the most impact in reducing heart disease, it is smoking cessation. Smoking increases your blood’s propensity to clot and damages the lining of the blood vessel predisposing it to blockages. It can be hard, as nicotine is one if not the most addictive substances but don’t give up. Nicotine alternatives and quit lines do help. See if your insurance pays for smoking cessation medications. Second hand smoke confers the same risks so avoid it.

Know Your Numbers – If you think you have risk factors for heart disease like family members with early heart attacks or any of the above factors, ask your doctor if it is appropriate for your age and risk factors to get a blood test for diabetes and cholesterol. Know your BMI or Body Mass Index as well. Anything above twenty-five is overweight and anything above thirty is obese.

Christabeth Boyd, MD, can be reached at 503.673.3400 or portlanddoctor.com